Troy Wilson
Analyst · Deutsche Bank. Your line is now open
Thank you, Pete, and thank you all for joining us this afternoon. The past quarter was highlighted by exciting data from our ongoing Phase 2 trial of tipifarnib in relapsed or refractory peripheral T-cell lymphoma. The data presented at both the European Hematology Association Annual Congress in Amsterdam and the International Congress on Malignant Lymphoma in Lugano marked the first prospective validation of CXCL12 pathway biomarkers to enrich for clinical activity of tipifarnib. The data showed a significant association between CXCL12 expression and clinical benefit including high levels of activity in both expansion cohorts: patients with angioimmunoblastic T-cell lymphoma an aggressive form of T-cell lymphoma often characterized by high levels of CXCL12 expression, and patients with PTCL who lack a single nucleotide variation in the 3-prime untranslated region of the CXCL12 gene. We believe these data are strong enough to support potential registration of tipifarnib in both patient populations and we intend to have discussions with regulatory authorities and key opinion leaders around next steps for the program. In addition, based on the extraordinary activity observed thus far, we plan to continue enrolling patients in the AITL cohort of our Phase 2 trial in order to acquire more experience regarding safety and tolerability in this population, and we expect to provide additional data from this cohort at a medical meeting later this year. We believe that based upon the revised 2017 WHO classification of T-cell lymphomas, AITL and related lymphomas represent approximately one-third of all PTCL cases. Our approach in CXCL12 driven PTCL has been consistent with the development strategy in HRAS mutant head and neck squamous cell carcinoma. We're primarily focused on indications where we can potentially drive single agent activity with durable objective responses. Further we seek to identify the subsets of patients who are most likely to respond to treatment. Such indications ideally can be pursued with smaller single arm registration-directed studies. Once we establish a foothold in a given indication, we can work toward broadening to earlier lines of therapy and expanding to larger patient populations either as a single agent or in combination approaches. In addition to establishing clear clinical proof of concept in T-cell lymphomas, we believe we've made significant progress toward broadening tipifarnib's potential to treat other CXCL12 driven indications of high unmet need. For example, we recently reported retrospective data from a Phase 2 trial of tipifarnib in patients with relapsed or refractory lymphomas. Our analysis identified pretreatment tumor CXCL12 expression and CXCL12 reference sequences as potential biomarkers of clinical benefit in patients with diffuse large B-cell lymphoma and mycosis fungoides, the most common form of cutaneous T-cell lymphoma. Further, recall earlier this year, we reported the identification of a potential association between CXCL12 expression and clinical benefit from tipifarnib in patients with pancreatic cancer. We continue to do additional pre-clinical work to validate tipifarnib in a CXCL12-high subpopulation of pancreatic cancer patients, and we expect to initiate a proof of concept study early next year. Over time, we believe CXCL12 pathway biomarkers could enable registrational strategies for tipifarnib in multiple hematologic and solid tumor indications. Now let's turn our attention to our most advanced program, HRAS mutant head and neck squamous cell carcinoma or HNSCC. The primary focus of the company continues to be the execution of our initial registration-directed trial of tipifarnib. To recap, the treatment cohort of our registration-directed study, which we call AIM-HN is to enroll -- which we call AIM-HN is designed to enroll at least 59 evaluable patients with HRAS mutant HNSCC, who have received prior platinum-based therapy. AIM-HN initiated in November 2018 and it is expected to take approximately two years to fully enroll. Meanwhile, we've enrolled additional patients in our ongoing Phase 2 trial of tipifarnib in HRAS mutant HNSCC, which we call RUN-HN. We plan to provide an update from RUN-HN at a medical meeting later this year. The update is expected to include follow up from ongoing patients as well as preliminary data on newly enrolled patients in both the HNSCC and other SCC cohorts. We remain enthusiastic about the potential for tipifarnib to treat patients with HRAS mutant tumors. Although our initial registration will focused on relapsed and/or refractory HRAS mutant HNSCC patients having HRAS variant allele frequency measurements greater than or equal to 20%, we see a broader opportunity set that includes combination therapies with immune therapies, cetuximab, and potentially chemotherapy. We intend to pursue these expanded indications as our resources permit. Consistent with our perspective on a larger set of development opportunities for tipifarnib, I'm pleased to report we've also expanded the patent protection for tipifarnib in both the U.S. and Europe. Last month we announced that the U.S. Patent and Trademark Office issued two new patents; a method of treating patients with HRAS mutant HNSCC with any farnesyl transferase inhibitor; and a method of treating patients with HRAS mutant non-small cell lung carcinoma with tipifarnib. In addition the European Patent Office granted a patent directed to the use of tipifarnib as a method of treating patients with HRAS mutant HNSCC. Each of these patents has an expiration date of August 2036 excluding any possibly patent term extension. These new patents strengthen our competitive advantage as we continue to advance the development of tipifarnib. We now own a number of independent issued patents covering tipifarnib and HRAS mutant HNSCC and we will continue to aggressively pursue additional intellectual property protection in the U.S. and abroad. Now, let's spend a moment on each of our emerging pipeline programs beginning with our ERK inhibitor KO-947. KO-947 is a potent and selective small molecule inhibitor of ERK which we are advancing as a potential treatment for patients with tumors that have dysregulated activity in the MAPK pathway. Our preclinical data suggest that KO-947 has anti-tumor activity in KRAS or BRAF mutant adenocarcinomas as well as certain subsets of squamous cell carcinomas. We continue to evaluate dosing regimens for KO-947 with a goal of reaching a recommended Phase 2 dose or maximum tolerated dose. We anticipate completing the dose escalation portion of our Phase 1 trial by the end of this year. In conducting the dose escalation trial for KO-947 our goals are to establish: a go-forward dosing schedule; an understanding of the safety and tolerability profile; pharmacokinetic and pharmacodynamics data; some ERK inhibition or other biomarker data; and any early signs of anti-tumor activity. Although most of the patients in the dose escalation portion of our study will be in difficult to treat populations such as pancreatic and colorectal cancer we believe our Phase one strategy will provide a solid foundation to make data-driven decisions for KO-947's best path forward. Our other emerging pipeline program is KO-539 a potent and selective small molecule inhibitor of the menin-mixed lineage leukemia or menin-MLL protein-protein interaction. We've generated preclinical data that support the potential anti-tumor activity of KO-539 in genetically defined subsets of acute leukemia including those with rearrangements or partial tandem duplications in the MLL gene as well as those with oncogenic driver mutations in genes such as NPM1. Last week we announced the FDA has granted Orphan Drug Designation to KO-539 for the treatment of acute myeloid leukemia. This decision by FDA follows the clearance of our investigational new drug application in March and it recognizes the potential for KO-539 to address a population of patients with high unmet need. Regulatory and clinical reviews have now been completed and we're in the final stages of study startup for our Phase 1 clinical trial of KO-539 in relapsed or refractory AML. With that I'll turn the call over to Marc Grasso for a discussion of our financial results for the second quarter of 2019.